An inside look at New Mexico’s largest mental health facility

LAS VEGAS, NM (KRKE) – From the streets to prison and back again. There are those who commit crimes in the community whom the courts deem “unfit to stand trial”, and as KRKE Investigates found, their cases often fail.

But what if the person found to be ‘unfit’ is also a danger?

KRKE Investigates shows viewers what’s going on when it comes to competency at New Mexico’s largest Institute for Behavioral Health in Las Vegas, New Mexico; how it works and who it serves.

The latest from KRKE research:

Tucked away in northern New Mexico, the Behavioral Health Institute, or BHI, has been in Las Vegas since 1889. The facility was originally known as the state’s “Territorial Insane.”

“The field has changed dramatically,” explained Dr. Tim Shields, BHI’s executive director. Shields and his staff at BHI do work that most people might shy away from.

“You know, there’s still a lot of stigma around working on an inpatient psychiatric unit or a forensics unit that it kind of scares people,” Shields explained. “Because sometimes it is considered more difficult to work with the population.”

Dr Shields added: “I would disagree. I think it’s more fun for them to work with the population and it’s more profitable to work with the population. But it’s hard to convince someone who’s never been on one of these units that, you know, hey, trust me – it’s fun.”

Long before modern medicine, a Las Vegas hospital housed people with behavioral health problems. “They would send them to these institutions all over the country,” Dr. Shields explained. “And then in the ’70s we started getting better drugs and kind of a different outlook.” And we’ve tried to move many of these facilities from detention – to treatment,” he said.

“We will actively treat their behavioral health condition and try to get them back into the community in a safe way,” explained Dr. Shields.

Exterior image of the Institute for Behavioral Health in Las Vegas, New Mexico.

The state hospital is overseen by the New Mexico Department of Health and is located on a sprawling 300-acre property with five departments:

  • Community-based services – provider of outpatient behavioral health services with community access.
  • CARE – Center for Adolescent Relationship Researchwhich is for ages 13-17.
  • Psychiatric department for adults – provides inpatient hospitalization for civil obligations, treatment of serious and persistent mental illnesses.
  • Meadows – a long-term care facility, such as a nursing home.
  • Forensic Division – treatment of defendants who are found to be unfit to stand trial and dangerous. Most people will be returned to the jurisdiction and released, while others are “non-returnable” and will remain there long-term.

What happens if someone is incompetent and dangerous?

The forensics unit serves a population of New Mexicans who have been ordered to be there by the court. “So these are individuals who are alleged to have committed a crime and then they go and talk to their defense attorney and they can’t help their defense attorney in their defense,” Dr. Shields explained.

It is the lawyers who raise the question of ‘competence’. If a court determines that a defendant is incompetent and dangerous, judges in every county in New Mexico can order that person to BHI in Las Vegas for treatment to help them become competent.

Most referrals to BHI come from Albuquerque. “It’s the biggest city, so we’re going to get a lot from there,” Dr. Shields said.

According to court records, Gerald Leon has been found ‘incompetent to stand trial’ in the past and was ordered to BHI in 2017. A criminal child abuse complaint against Leon states that a group of high school students reported that Leon assaulted them. with a three-foot stick at Bataan Memorial Park and hit a boy across the face in 2016.

Image of an APD officer giving Gerald Leon a criminal possession notice at a Walgreens in Albuquerque.

When someone is ordered BHI, Dr. Shields explains that he and his medical staff work to treat the underlying cause of the person’s symptoms. “We treat them like people.” Many times in the community everyone runs away from people who react to internal stimuli or try to avoid it. We do not have. We go to them, we talk to them, we make them feel safe,” Shields added.

Returning to life outside the hospital has its challenges

After treatment in Las Vegas, Leon was released and pleaded guilty to child abuse. With credit for time served, he spent one year at MCD.

However, the police would get calls about him again. “And who all got hit on?” An Albuquerque police officer is heard on the lapel tape responding to a call at the Walgreens at 2021 Central and Eubank. The security guard replied, “All of us. My face is burning.”

Albuquerque police officers took that report after workers said Leon cursed at them unprovoked and then punched three security guards. “He came up to us and just started throwing himself out,” explained one guard.

Security guards said they were able to handcuff Leon and waited at least an hour for APD to respond to the store. “I don’t want to just let him fly,” the guard told the APD officer.

After viewing security footage and speaking with employees, an APD officer explained, “I can take the case to the courts, but I can’t take him anywhere. The officer told Walgreens staff and security that Leon was not going to jail that night.

When the Walgreens manager asked the officer why Leon wouldn’t be arrested, the officer replied, “Because in the state of New Mexico, aggravated assault, misdemeanor level, is not an arrestable offense.” A criminal report was the best a police officer could do, he explained.

“He doesn’t care,” a frustrated Walgreens manager told the officer. “You know, people who have nothing to lose, they don’t care – those are the ones who are a threat to me.”

The Walgreens manager went on to tell the officer about other encounters she had dealt with at the store, with people with obvious mental health issues. She also expressed frustration with the delayed or no response from police and the “low priority” status from dispatchers that does not require a quick response.

“Because he needs medication,” the manager explained. “I’m afraid he will come and act like a fool with us and no one will be able to protect us in time,” she told the officer.

“We’re just frustrated,” the guard said. “Of course. And I don’t blame you,” the APD officer replied.

Leon’s criminal record is extensive and dates back 23 years. His charges include aggravated assault, assault and a child abuse case in Bataan Park.

Does the process work?

Once someone is released from BHI Las Vegas, a place where they receive help from medical professionals, there are often other challenges. Whether a person continues on the right path depends on the support of the individual and the community.

When asked if the process works for humans, KC Quirk said, “I would say not so much. Quirk is director of the Social Work Unit at the Albuquerque Public Defender’s Office, or LOPD.

“Whether someone can meet the criteria to be competent to stand trial is completely different from whether that person’s health is taken care of,” Quirk explained. She also said there is a missed opportunity to put someone through a mental health evaluation, which in many cases does not result in that person receiving comprehensive services.

And that’s where resources outside of hospitals and prisons come into play, especially since stays at BHI Las Vegas are intended to be temporary.

A patient room at the Institute for Behavioral Health in Las Vegas, New Mexico.

“It’s kind of a warm handover,” explained Dr. Shields, referring to the process of releasing defendants from BHI. Shields said 80% of defendants sent to BHI return fit to stand trial, usually within the first six months.

“There are a lot of good community programs in New Mexico,” Dr. Shields said. “But that’s usually where we need more help when we release someone from here – are we sure they’re going to have a safe place to stay?” Are we sure that place is going to make sure they go to their appointments, that they’re going to take their medication?”

Another source in ‘Mental Health Court’

Circuit Court Judges Lucy Solimon and Bruce Fox preside over the Bernalillo County Mental Health Court, a diversion program that aims to tackle the root causes of crime, such as substance abuse and behavioral health.

“These diversion courts started, you know, 30 years ago with drug court,” Judge Fox explained. “The idea was to provide an alternative to probation and prison.

Attorneys can refer defendants to the program, usually as part of a plea deal. “Other times, a judge may also order it as part of a condition of release,” Judge Solimon explained. “If I look at a case or their history and they see a pattern, sometimes you can tell that going to mental health court might be the right way to go.”

Bernalillo County Circuit Court Judges Lucy Solimon and Bruce Fox preside over the Mental Health Court program.

The judges agreed that one of the biggest obstacles for a defendant is usually stable housing and access to medical care. “It’s already difficult for a lot of people who have very bright minds, intelligent backgrounds,” Judge Fox explained. “And you can imagine that someone is not quite properly treated and has to renew their prescription.”

“The greatest success I see here in the district court is when you provide people with the resources they need to change their behavior, get the medication they need, get them stable housing, address their substance abuse,” Judge Solimon said. “And to get to a point where they can have a stable life and not offend again.”

However, the judges said that the person must be self-motivated. Treatment through a mental health court is voluntary. “We really tried to get people to open up, to talk, to get team members to give advice,” Judge Fox said. “It’s really a collaborative effort.”

He also said that diversionary courts have the ability to overcome the prosecutorial courtroom, where lawyers for both sides try to win a case. In mental health court, lawyers on both sides, judges and medical professionals are on the defendant’s team, Fox explained.

But what about those who can’t or won’t help themselves?

KRKE asked about civil liability, another legal process in which a doctor signs off, and a person with behavioral health problems can be involuntarily committed to treatment. It happens, but it’s rare.

“It gets a little complicated because you’re talking about civil rights and taking away someone’s liberty, basically,” Judge Fox said.

“The reason our civil commitment standards are where they are today is because that civil commitment process has been abused and people have been abused,” Quirk explained. “And back in the ’80s and ’90s, there was this massive deinstitutionalization in our mental health facilities, right? But we haven’t created safety nets.”

In a system where getting people help can seem like an uphill battle, Dr. Shields points out, “Statistically speaking, individuals with serious and persistent behavioral health problems are far more likely to be victims of crime than perpetrators of crime. “

“The more we can replicate that and let people know that this is a good population to work with, they need support, they need to be treated well,” Shields explained. “You see some really great results with that.”

BHI in Las Vegas employs nearly 600 staff members across its campus. Dr. Shields said BHI needs more direct care staff. “Thank God there are people who want to help people bathe and, you know, help them eat and, all these things are really honorable things to do,” Dr. Shields said.

Exterior of the current ‘Forensic Unit’ at BHI in Las Vegas, New Mexico.

The state legislature recently approved $68 million to replace the aging forensics unit in Las Vegas, which will increase the hospital’s capacity. The new unit is expected to open in 2026.

The average length of stay in BHI that should be treated as competence is six months, but there are some accused who stay there even longer. That was the case with John Hyde, the man accused of randomly killing five people in 2005.

Hyde has been found incompetent to stand trial and is serving what would be life in prison in a Las Vegas hospital. While he is there, forensic psychologists are still updating the courts on his mental status.

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